For more information on the Pharmacy Deductible and examples, view the GatorCare Pharmacy Deductible page

Member pays the brand copay plus the difference in cost between the brand and generic if brand product is chosen when a generic equivalent is available.

There is a mandatory 90-day supply at either retail or mail order for Tier 1 or 2 maintenance medications following a maximum of two 30-day fills at retail. Controlled drugs including, but not limited to, medications used to treat anxiety, sleep, pain, and hyperactivity disorders are EXCLUDED from the mandatory 90-day Rx rule.

How to Look Up the Tier of a Specific Medication

Step 2. After navigating to this page, enter the name of the drug on the left hand side.

Step 3. After several seconds, possible matches appear on the right side of the screen. The tier to which the drug is offered through GatorCare is found along with other alternative drugs and information.

Step 4. By clicking on the ‘find alternative drugs’ link, a member can determine if an alternative medication for the drug may be available on a lower tier, reducing the member’s out-of-pocket expenses.

Tier 1

Option with the lowest out-of-pocket expenses and a pharmacy deductible does not apply

Generic medications

Up to a 30-day supply

You pay 25% of the total price of the medication with a $10 minimum payment, and a $20 maximum payment

Up to a 90-day supply

You pay 25% of the total price of the medication with a $25 minimum payment, and a $50 maximum payment.

Maintenance medication

After filling a maintenance medication two times, you are required to have it filled with a 90-day prescription. There are a few exceptions to this, including, controlled drugs for anxiety, sleep, pain, and hyperactivity disorders. For clarification, please contact MagellanRx Management, at 800-651-8921.

Tier 2

Preferred Brand Medications – a pharmacy deductible applies and you are required to pay the first $100 out-of-pocket expenses to satisfy the deductible

Up to a 30-day supply

You pay 25% of the total price of the medication with a $25 minimum payment, and a $50 maximum payment.

Up to a 90-day supply

You pay 25% of the total price of the medication with a $62.50 minimum payment, and a $125 maximum payment.

Maintenance medication

After filling a maintenance medication two times, you are required to have it filled with a 90-day prescription. There are a few exceptions to this, including, controlled drugs for anxiety, sleep, pain, and hyperactivity disorders. For clarification, please contact MagellanRx Management, at 800-651-8921.

Tier 3

Preferred Specialty Medications – a pharmacy deductible applies and you are required to pay the first $100 out-of-pocket expenses to satisfy the deductible

Up to a 30-day supply

You pay 25% of the total price of the medication with a $50 minimum payment, and a $100 maximum payment.

90-day supplies are not available for Tier 3 medications

Tier 4

Non-preferred Brand Medications – a pharmacy deductible applies and you are required to pay the first $100 out-of-pocket expenses to satisfy the deductible

Up to a 30-day supply

You pay 40% of the total price of the medication with a $70 minimum payment and a $240 maximum payment

Up to a 90-day supply

You pay 40% of the total price of the medication with a $175 minimum payment and a $600 maximum payment

Tier 5

Non-preferred Specialty Medications – a pharmacy deductible applies and you are required to pay the first $100 out-of-pocket expenses to satisfy the deductible

Up to a 30-day supply

You pay 40% of the total price of the medication with a $70 minimum payment and a $240 maximum payment